Medicine and Health Sciences Commons^™

The Clinical Value Of Oculomotor Assessments Across The Continuum Of Concussion, Dillon Richards

Electronic Thesis and Dissertation Repository

Concussions are complex conditions that are difficult to manage medically. Variations in symptom presentation, intricate neurophysiological processes, and the availability of a variety of possible assessment tools may contribute to this complexity. Clinicians must use a broad approach, employing both subjective symptom assessment and objective assessments to confirm a diagnosis and/or monitor progression and recovery. Oculomotor function after concussion may be an important indicator of injury, given the interconnectedness of oculomotor function, vestibulo-ocular and visual systems, and even cognition. Oculomotor function may be assessed objectively or indirectly using patient-reported symptom checklists as part of subjective assessments. One way of objectively …

Exploring The Inter-Relationship Between Cognitive And Motor Function In People With Lower Limb Amputations, Humberto Adolfo Omaña Moreno

Electronic Thesis and Dissertation Repository

The main objective of the present dissertation was to expand our understanding of the inter-relationship between cognition and mobility in people with lower limb amputations (PLLA). Study 1 systematically reviewed the literature to assess the effects of dual-task testing on the balance and gait of PLLA. A total of twenty-two studies were included. Overall, PLLA demonstrated a disproportionately greater dual-task effect than controls, characterized by increased sway velocity and reduced pace and rhythm, and increased asymmetry when balance or walking was paired with a secondary task. Additionally, the dual-task effect was not influenced by differences in etiology, level of amputation, …

The Genetics Of Pain: An Exploration Of Gene-By-Environment Interactions And Their Effects On Pain, Mohamad F. Fakhereddin

Electronic Thesis and Dissertation Repository

The findings presented in this dissertation are part of the bigger SYMBIOME project which aims to use the biopsychosocial model of pain to develop a prognostic clinical phenotype for people that experience musculoskeletal (MSK) trauma. Chapter 2 presents an exploratory analysis to assess the relationships between genetic polymorphisms and pain severity and interference. Early childhood trauma was also explored as a moderator between genetic polymorphisms and pain outcomes. For pain severity, major allele carriers (A/A and G/A) of FKBP5 rs9394314 reported significantly higher scores than minor allele carriers (G/G). Further, major allele carriers who had at least one adverse childhood …

Perspectives Of Canadian University Coaches On Integrating Sport Psychology And Mental Performance Consultants In Varsity Programs, Federico Cisneros Sánchez

Electronic Thesis and Dissertation Repository

Recently, sport psychology has become a more popular resource for athletes and coaches when looking to increase performance. It is unknown how many Canadian universities utilize sport psychology services in their athletic programs. Semi-structured interviews were conducted with coaches of Canadian university varsity teams to learn about their opinions on sport psychology and mental performance consultants (MPCs). The research was approached from a pragmatic perspective. Results showed that MPCs are important to enhance performance and provide mental health resources. MPCs provide athletes with personal and leadership development, mental skills training, and mental health support. MPCs can also be a resource …

Assessment Of Intrinsic Hand Neuromuscular Physiology, Philemon Tsang

Electronic Thesis and Dissertation Repository

Alterations to the peripheral nervous system and neuromuscular physiology may impact hand function in a typical or clinical population, such as individuals with ulnar neuropathy. The mechanisms that influence these positive and negative changes are still not well understood. The three studies within my thesis aim to validate the reliability of decomposition-based quantitative electromyography (DQEMG) measurements and explore the changes in intrinsic hand neuromuscular physiology in a typical aging population and individuals recovering from a surgical intervention for severe ulnar neuropathy.

The purpose of the first study was to determine the test-retest reliability of near-fibre (NF) jiggle, a measure of …

Does An Acute Achilles Tendon Rupture Become A Patient's Achilles Heel In The Long-Term?, Michaela Cm Khan

Electronic Thesis and Dissertation Repository

It is unknown if deficits in the involved limb following acute Achilles tendon rupture (AATR) persist in the long-term, or differ between patients treated operatively or non-operatively. This study investigated 43 patients 15±1 years post-AATR from a previous randomized controlled trial (RCT) that compared operative and non-operative treatment. Structural characteristics in the Achilles tendon and surrounding musculature were assessed using magnetic resonance imaging. We also performed physical examinations and evaluated performance-based and patient-reported outcomes. Overall, there were substantial differences between the involved and uninvolved limbs in most outcomes. Some outcomes improved over time from the initial RCT to the final …

Recovery Following Proximal Humerus Fracture, Azar Varahrami Vigeh

Electronic Thesis and Dissertation Repository

There is currently a glaring gap in the existing knowledge to address individuals’ experiences while recovering from a proximal humeral fracture (PHF). The main objective of this dissertation was to understand better how recovery is perceived by individuals after PHF. This overarching objective aligned well with the broad conceptualization of the issue at hand as those provided by the International Classification of Functioning, Disability and Health (ICF). Three inter-linked studies were conducted to provide a broader picture of recovery after PHF. The first study was a systematic review of prognostic factors predicting recovery after PHF in adults. This review demonstrated …

Constraining Kinematics During Single-Leg Squats And Step-Ups Can Reduce Quadratus Lumborum Activation And Facilitate Gluteal Activation, Shaylyn Kowalchuk

Electronic Thesis and Dissertation Repository

Increased quadratus lumborum activation and decreased gluteal activation may lead to lateral pelvic drop and increased hip adduction and internal rotation during single-leg exercises. These activation patterns and motions are associated with low back pain or lower extremity injuries. The purpose of this study was to evaluate if mechanically restricting hip adduction and internal rotation of the femur affected muscle activation. Twenty female track and field athletes performed single-leg squats and step-ups, and the quadratus lumborum, gluteus medius and maximus muscles activations were measured with surface electromyography. This study tested the hypothesis that mechanically restricted exercises would decrease quadratus lumborum …

Inpatient Versus Outpatient Total Hip Arthroplasty, Michael Pollock

Electronic Thesis and Dissertation Repository

We conducted a randomized controlled trial to evaluate patients undergoing a total hip arthroplasty (THA) who were discharged from the hospital either on the day of surgery (outpatient) or were admitted overnight following surgery (inpatient). Our primary outcome was the rate of serious adverse events during the first three months postoperatively. Secondary outcome measures included cost, patient satisfaction, functional outcomes, quality of life and pain. We found no statistically significant difference between the two groups in serious adverse events. We found that outpatient THA was less expensive from the perspectives of the hospital and ministry of health; but the difference …